Pietropaolo Amelia, Bres-Niewada Ewa, Skolarikos Andreas, Liatsikos Evangelos, Kallidonis Panagiotis, Aboumarzouk Omar, Tailly Thomas, Proietti Silvia, Traxer Oliver, Giusti Guido, Rukin Nick, Özsoy Mehmet, Talso Michele, Emre Sener Tarik, Emiliani Esteban, Atis Gokhan, Somani Bhaskar K
University Hospital Southampton NHS Foundation Trust, Department of Urology, Southampton, United Kingdom.
Roefler Memorial Hospital, Department of Urology, Pruszków, Poland.
Cent European J Urol. 2019;72(4):393-397. doi: 10.5173/ceju.2019.0041. Epub 2019 Oct 14.
To understand the current practice of flexible ureteroscopy (fURS), we conducted a worldwide survey among urologists with a special interest in endourology.
A 42-question survey was designed after an initial consultation with European Association of Urology young academic urologists (YAU) and uro-technology (ESUT) groups. This was distributed via the SurveyMonkey platform and an ESUT meeting to cover practice patterns and techniques in regard to ureteroscopy usage worldwide.
A total of 114 completed responses were obtained. A safety guidewire was reportedly used by 84.5% of endourologists, an access sheath was always or almost always used by 71% and a reusable laser fibre was used by two-thirds of respondents. While a combination of dusting and fragmentation was used by 47% as a preferred mode of intra-renal stone treatment, some used dusting (43%) or fragmentation with basketing (10%).Disposable scopes were only used by 40% and three quarters of them used it for challenging cases only. Antibiotic prophylaxis was limited to a single peri-operative dose by two-thirds (67%) of respondents. The procedural time was limited to between 1-2 hours by two-thirds (70%) of respondents and very rarely (7.4%) it exceeded 2 hours. The irrigation method varied between manual pump (46%), mechanical irrigation (22%) or gravity irrigation (27%).
Our survey shows a wide variation in the available endourological armamentarium and surgical practice amongst urologists. However, there seems to be a broad agreement in the use of peri-operative antibiotics, access sheath usage, method of stone treatment and the use of post-operative stent.
为了解软性输尿管镜检查（fURS）的当前实践情况，我们对专注于腔内泌尿外科的泌尿外科医生进行了一项全球调查。
在与欧洲泌尿外科协会青年学术泌尿外科医生（YAU）和泌尿外科技术（ESUT）小组进行初步磋商后，设计了一份包含42个问题的调查问卷。该问卷通过SurveyMonkey平台和一次ESUT会议进行分发，以涵盖全球范围内输尿管镜使用的实践模式和技术。
共获得114份完整回复。据报道，84.5%的腔内泌尿外科医生使用安全导丝，71%的医生总是或几乎总是使用接入鞘，三分之二的受访者使用可重复使用的激光光纤。虽然47%的医生将粉末化和碎石术结合作为肾内结石治疗的首选模式，但也有一些医生使用粉末化（43%）或套篮碎石术（10%）。仅40%的医生使用一次性输尿管镜，其中四分之三的医生仅在具有挑战性的病例中使用。三分之二（67%）的受访者将抗生素预防限制在围手术期单次给药。三分之二（70%）的受访者将手术时间限制在1至2小时之间，很少（7.4%）超过2小时。冲洗方法在手动泵冲洗（46%）、机械冲洗（22%）或重力冲洗（27%）之间有所不同。
我们的调查显示，泌尿外科医生在可用的腔内泌尿外科设备和手术实践方面存在很大差异。然而，在围手术期抗生素的使用、接入鞘的使用、结石治疗方法和术后支架的使用方面似乎存在广泛共识。
